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1851749725
MARIO BAUTISTA
JAMAICA, NY
NPI
1851749725
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 097096-1)
Enumeration Date
2016-06-01
Last Update Date
2016-06-01
Business Address
-- MARIO BAUTISTA
13325 GUY R BREWER BLVD
JAMAICA, NY 11434-2941
Phone number: 718-276-2508
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Mailing Address
-- MARIO BAUTISTA
26 W SEAMAN AVE
FREEPORT, NY 11520-1547
Phone number:
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